Rival Health Plans Rejected

First Lady Says All Must Be Covered

November 09, 1993|By Carol Jouzaitis, Tribune Staff Writer.

WASHINGTON — Firing the administration's first shot in the legislative fight over changing the nation's health-care system, Hillary Rodham Clinton on Monday vigorously rejected all but two proposals competing with the White House package: a more liberal, Canadian-style single-payer plan proposed by Democrats and a more conservative, Republican-sponsored plan.

After weeks of courting Congress in the health-care debate as she sought to widen support for President Clinton's goals, the first lady began drawing battle lines over elements of the White House plan that she said are not open to negotiation.

In doing so, she began whittling down the administration's field of legislative allies on the issue and more sharply defined the president's bottom line.

And, having previously stressed that the administration has "no pride of ownership" in its package, she said she wanted to correct any impression that all aspects of it are subject to discussion.

"Everything in this debate is not equal," Mrs. Clinton said in her first briefing for reporters on the White House program.

After her counterattack last week on insurance companies that had criticized Clinton's plan, she warned that other White House opponents should expect a tough fight as well.

"If the forces arrayed against reform want a real battle in which their self-interest is exposed and their real agenda is made public, they'll get it," she declared.

While the White House is willing to "meld approaches" with its allies, Mrs. Clinton reiterated that the president will not compromise on several key principles. Most important, she said, he will not sign any bill that doesn't provide universal coverage with a comprehensive, afforable set of benefits.

She said most of the health-care proposals floating around Congress aim at changing the private insurance market in order to make coverage easier or cheaper to obtain. But those proposals are unacceptable if they don't include mechanisms for guaranteeing coverage to all Americans, she said.

It's "a huge leap" from giving all Americans access to coverage to assuring that all Americans would be provided coverage, she said.

And, in an elaboration of the White House's requirements, Mrs. Clinton said the benefits package should be spelled out, with a price tag attached, so Americans will know beforehand what type of coverage they can count on.

She said that without those several elements, the program would not achieve the desired cost savings or reduction in the federal budget deficit.

The first lady said that besides Clinton's program, only one other plan met each of those tests: the proposal for a government-run, single-payer system, which a number of Democrats support.

Single-payer is the most liberal of the proposals. Advocates insist it would be simpler and more straightforward than Clinton's program, but critics say it would be a nightmare of socialism.

"From our perspective, other than the single-payer, there is no other bill," Mrs. Clinton said.

However, she didn't rule out a bill sponsored by Sen. John Chafee (R-R.I.), and backed by other Republicans, that is similar to Clinton's managed-competition program. Chafee's proposal provides for universal coverage but it doesn't place a mandate on employers, as Clinton's does.

Mrs. Clinton said that the single-payer and Chafee plans "move us in the direction that we think has to be achieved."

She ruled out all other health-care proposals, including those by Rep. Jim Cooper (D-Tenn.), Sen. John Breaux (D-La.) and Sen. Phil Gramm (R-Texas). None of them assures universal coverage, she said.

"There really cannot be any comparison of the president's plan with those," she said.

She was especially critical of Cooper's plan, which has been dubbed the "Clinton-lite plan" and even has been viewed by some as a possible model for a compromise bill.

Cooper's plan leaves the benefits package to be determined at a future date by a national board and would give insurance companies too much leeway to change the package, she said.

Nonetheless, Mrs. Clinton said the White House was willing to consider a range of alternatives in achieving universal coverage and a defined benefits package.

She said that among the negotiable elements of Clinton's package are how purchasing alliances should be constructed, how large they should be, and how premiums would be collected.

Mrs. Clinton defended the White House program against criticisms that it is too bureaucratic, saying it would eliminate much of the government micromanagement involved in the current system.